護理師正在諮詢一位個案戒菸。個案說：「我知道吸菸對我不好，我一直在考慮下個月要戒菸。」根據跨理論模型，個案處於哪個改變階段？

本題考察護理師對於跨理論模型（Transtheoretical Model, TTM）中行為改變階段的理解。TTM 是一個廣泛應用於健康行為改變的理論框架，它將行為改變視為一個動態的、循環的過程，包含數個階段。護理師運用此模型，可以評估個案所處的階段，並提供針對性的介入策略。 個案的陳述「我知道吸菸對我不好，我一直在考慮下個月要戒菸」是本題的關鍵。正確答案 B 指出個案處於「準備階段」（Preparation）。在準備階段，個案已經決定在近期（通常是未來一個月內）採取行動來改變行為，並且可能已經制定了初步的計畫。這比僅僅考慮改變（沉思階段）更進一步。 護理師需精確判斷個案的改變階段，才能提供最有效的支持和引導。例如，對於準備階段的個案，護理師應協助其制定具體的行動計畫和應對策略。

This item tests the nurse's understanding of the stages of behavior change within the Transtheoretical Model (TTM). TTM is a widely used theoretical framework for health behavior change that views behavior change as a dynamic, cyclic process composed of several stages. By using this model, the nurse can identify the client's stage and provide stage-specific interventions. The client's statement, "I know smoking is bad for me, and I have been thinking about quitting next month," is the key to this item. The correct answer, B, identifies that the client is in the preparation stage. In the preparation stage, the client has decided to take action to change a behavior in the near future (usually within the next month) and may have already drawn up an initial plan. This is one step beyond merely considering change (contemplation). The nurse must accurately identify the client's stage of change in order to provide the most effective support and guidance. For a client in the preparation stage, for example, the nurse should help develop a specific action plan and coping strategies.

跨理論模型（Transtheoretical Model）是健康行為改變領域的重要理論框架，在台美兩地的護理教育和臨床實踐中均被廣泛教授和應用。護理師會利用此模型評估個案的改變意願，並依據其所處階段提供相應的衛教和支持。無論在美國或台灣，戒菸諮詢、慢性病管理衛教等領域，護理師都會運用類似的溝通技巧和介入策略，以促進個案的行為改變，因此在實踐上沒有顯著差異。